The effects of multisensory stimulation on the length of hospital stay and weight gain in hospitalized preterm infants: A systematic review with meta-analysis

Abstract

Background: Multisensory interventions, such as auditory-tactile-visual-vestibular intervention (ATVV), tactile-kinesthesic stimulation (TKS), and the kangaroo mother care (KMC), have been commonly applied in hospitalized preterm infants.

Objective: To investigate the effectiveness of the ATVV, the TKS, and the KMC combined to standard care compared to standard care in the length of hospital stay and weight gain of hospitalized preterm infants.

Methods: PubMed, Scopus, Web of Science, Embase, SciELO Citation Index, CINAHL, Cochrane, and LILACS databases were searched from the inception to May 06, 2022 without language restrictions. We included randomized controlled trials. Two independent reviewers selected studies and extracted information about participants, interventions, outcomes, and the risk of bias. The body of evidence was synthesized through GRADE. Data were pooled using a random-effects model.

Results: Sixty-three randomized clinical trials included a range of 20-488 preterm infants (gestational age=25 to <37 weeks). Evidence was low to very low due to risk of bias, inconsistency, and imprecision. Most studies presented some concerns about methodological quality. The ATVV and the KMC increased weight gain. The TKS reduced the number of days at the hospital and increased the daily weight gain and the total weight gain.

Conclusions: Adding ATVV, TKS, or KMC to standard care was more effective than standard care alone to improve weight gain. Only the TKS combined with standard care was more effective than standard care alone to reduce the length of hospital stay.

Keywords: Clinical trial; Early intervention; Premature infant.

Fig. 1

Forest plot for effect of the Auditory–Tactile–Visual-Vestibular Intervention (ATVV) combined with standard care compared with standard care alone on the length of hospital stay, the final weight, the daily weight gain, and the total weight gain.

Fig. 2

Forest plot for effect of the tactile-kinesthesic-stimulation (TKS) combined with standard care compared with standard care alone on the length of hospital stay, the final weight, the daily weight gain, and the total weight gain.

Fig. 3

Forest plot for effect of the kangaroo mother care (KMC) combined with standard care compared with standard care alone on the length of hospital stay, the final weight, the daily weight gain, and the total weight gain.